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Depression in the Aging

Date: 03/16/2007 Source: Theodore J. Ruza, D.O.

Depression in the older adult population is a major health problem yet the condition is frequently unrecognized, undiagnosed and untreated. Of the more than 30 million Americans over age 65, approximately five percent suffer from serious symptoms of depression. As the population continues to age, the suffering, burden to families and diminished physical capacity associated with depression are expected to increase.

Despite this troubling picture, there is promising news. According to Theodore J. Ruza, D.O., a Botsford Hospital psychiatrist, depression in the elderly can be treated effectively and safely in most cases.

Unfortunately, depression in older adults is frequently more difficult to diagnose than in younger patients. It often coexists with physical illnesses such as stroke, Parkinson's disease, or heart disease which can hide or blur its symptoms. Depression is not part of the normal aging process and should not be considered part of growing older. Stereotypes of the elderly as irritable or cranky may prevent family members and even primary care physicians from recognizing symptoms of depression. In addition, said Dr. Ruza, many older adults believe that there is a stigma attached to mental illness and therefore fail to seek help. "No one wants to be thought of as that crazy old person," he said.

Dr. Ruza described the common symptoms of depression as feelings of sadness coupled with hopelessness and helplessness. Other symptoms such as loss of appetite, lack of energy and motivation and difficulty in concentrating frequently accompany the condition, he said.

Treatment can bring dramatic improvements and is usually highly effective in relieving the symptoms of depression. Many new antidepressant medications - most with few side effects - are being prescribed by physicians to treat the condition. However, Dr. Ruza generally recommends a combination of medication and one-on-one counseling sessions as the most effective treatment. This technique also helps assure that the patient is monitored for side effects of the medication.

Untreated, depression can lead to disability or premature death, worsen the symptoms of other illnesses, or result in suicide.

As in younger populations, depression can recur. Dr. Ruza said that family and other social support can be critical to preventing a recurrence. He suggests that older adults develop a network of friends and family members who can help them deal with illness and other life changes. "Most important is a strong relationship with a primary care physician," he said.

Depression in an older adult is not the same as grief nor is it a passing mood. It is not a personal weakness or something that can be willed away. It is a serious illness that affects both mind and body. With help from a physician experienced in geriatric depression, most older adults CAN be treated successfully.